Tip Definition Via Rhinoplasty Difficult for Ethnic Nose?

Is it difficult to get definition via Rhinoplasty with a bulbous ethnic nose? How much change in appearance can one expect if it looks round and the desired look is a pointy one?

Doctor Answers 17

Tip definition via Rhinoplasty for ethnic nose

Hi Corey,

Naturally, in all races the nasal tip skin is much thicker than the skin at the root of the nose (between the brows). For the shape of the nasal framework to be seen by the outside world, the overlying skin has to be both thin enough and pliable enough to DRAPE over the framework. The thicker and the less pliable the skin (such as in Black or Mexican-Mestizo noses), the less it will drape gracefully over the frame work.

In rhinoplasty, tip refinement can be done by narrowing the (lower lateral) cartilages of the tip, suturing them closer together thereby increasing their tip defining points, and repositioning the tip higher on the frontal (caudal) end of the septum for a higher tip projection. In thicker skin patients, in whom the skin has "memory" and refuses to drape over the new narrower framework, cartilage graft(s) (from the septum or ear) may need to be stacked on the tip to get the skin to drape better over it.

But - each case is very individual and the surgeons doing such cases always walk a thin line between refining the nasal tip without either feminizing a male nose or crossing ethnic boundaries and inappropriately creating an ethnically out of place nose.

I hope this was helpful.

Memphis Plastic Surgeon
5.0 out of 5 stars 93 reviews

Nasal tip definition with ethnic noses

Calicorey, the word 'difficult' is a relative term when it comes to rhinoplasty. Less experienced surgeons may find this type of change quite challenging. Surgeons with extensive training and experience in rhinoplasty should be able to provide you with a noticeable esthetic improvement. Most ethnic noses tend to have thicker overlying skin, which necessitates specialized maneuvers to create more tip definition. The underlying cartilage structure will also be an important factor. In some cases, adding additional cartilage to the tip may be warranted to achieve the desired shape. In many cases, this is a better alternative than resecting, or cutting, cartilage to narrow the tip. In the end, the goal would be to provide you with sufficient amount of tip definition without creating a nose that is structurally compromised or appears surgically altered.

John M. Hilinski, MD
San Diego Facial Plastic Surgeon
4.5 out of 5 stars 28 reviews

Ethnic Bulbous TIp

There are several types of bulbous tips. Ethnic, cartilaginous and bulbous tips caused by scar tissue from previous rhinoplasty. From looking at your pics, it looks like you have a cartilaginous bulbous tip. The best way to see potential results is to have computer imaging on your nose to see what your nose could look like.
See video link below for further information

Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
5.0 out of 5 stars 252 reviews

Tip Definition Via Rhinoplasty Difficult for Ethnic Nose?

Tip definition can be enhanced in an ethnic nose, and the aesthetic results depend on your anatomy and skin thickness.  Computer imaging can preview the results.  Make sure you consult with a few surgeons experienced in ethnic rhinoplasty and look at plenty of their b/a pictures. 

Ramtin Kassir, MD
New York Facial Plastic Surgeon
4.5 out of 5 stars 106 reviews

With ethnic rhinoplasty it is difficult to create a pointed nose due to thicker skin,

With ethnic rhinoplasty it is sometimes difficult to give a pointed nose due to excess thick, oily, sebaceous skin. Certainly, the ethnic tip can be refined. The rhinoplasty operation is a sculpting of both bone and cartilage for refinement purposes. It is not skin surgery. The skin itself cannot be thinned with a rhinoplasty or a tip plasty operation. Thick skin will always cover up and blunt the sculpting that is done on the tip.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.5 out of 5 stars 107 reviews

Tip Definition in Bulbous Ethnic Nose

Yes, it is difficult to get good tip definition in a bulbous ethnic nose, but improvement can be achieved, whether the appearance is due to thick skin or weak cartilages. During consultation with an experienced surgeon you will be able to establish reasonable expectations. Until that time, be optomistic; you may be pleasantly surprised.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 32 reviews

Improved tip definition in an ethnic rhinoplasty

While it is more difficult to see immediate significant differences in tip definition after rhinoplasty on folks with thicker skin, it can be done, but the final result will take some time to see and may require a second, minor in-office procedure. The key is to be patient and work with your surgeon, but don't expect to see significant tip definition right away after surgery as we would expect in say a rhinoplasty on a Caucasian with very thin tip skin. It may take several months or longer to see the final result, and so the key here is good communication with your surgeon as to what to expect.

Shahram Salemy, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 134 reviews

Nasal tip refinement


The problem with refining an ethnic nasal tip is getting the refinement to project externally. The usually thick ethnic nasal skin covers the surgically refined tip cartilage much like a thick blanket being thrown over your body. If the blanket is thick enough, you may not even know that there is a person beneath it. So if you have very thick nasal tip skin, your refined nasal tip will not show through. Good luck!

Achieving a pointy (defined and projecting) nasal tip with a round bulbous ethnic type nose job

Despite the best efforts to "sculpt" the tip of the nose, the thickness of the skin may be the limiting factor and prevent one from achieving a pointy nose. It is very difficult to thin the skin without complications (this probably occurred with Michael Jackson's nose). The alternative is to build up the nose to tent the thick skin and create the illusion of a pointy nose. This may require cartilage grafts from the septum, ear, or rib. Although it is not popular in the USA, silicone implants are very popular for this exact purpose in the Pacific Rim. Although they are relatively easy to perform and relatively inexpensive when compared to traditional rhinoplasty, these do have a lifetime risk of infection and/or exposure.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 69 reviews

Bulbous tip definition

Each patient is different. Yes, if the skin is very oily and thick, it may be difficult to really accentuate the tip. If the tip is thinner, than the bulbosity can be improved more easily.

Steven Wallach, MD
New York Plastic Surgeon
4.0 out of 5 stars 23 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.